Ask me about pressure ulcers – I can tell you anything you want to know. It’s what I’ve done for 15 years, so I know it inside and out, and it’s where I’ve gotten the bulk of my cases. I’m also good with falls, acute care and some long term care, but pressure ulcers – that’s my field. I will go up against anybody, anywhere, anytime.
I started consulting with attorneys immediately after graduating from Vickie Milazzo Institute’s Certified Legal Nurse Consultant Certification Program. My daughter-in-law is a real estate attorney. They have to keep up their continuing legal education (CLE) credits, so she said, “Come to this conference. You can sponsor the coffee and Danish. Your name will be there on a plaque, and you can chat with the attorneys during breaks.”
About three-quarters through the meeting, I was asked to speak for five minutes. My daughter-in-law said, “Remember, attorneys don’t want to be there. These are not billable hours. So whatever you do, get in, get to the point, get out and make an impression,” – the same thing Vickie tells us in the CLNC Certification Program. This event gave me the courage to call the event coordinator and say, “I’d like to speak to the attorneys at one of your meetings. I have a number of topics, but I’m especially knowledgeable on pressure ulcers.”
She said, “Hmmm, I don’t know. Let me pass this along.” She got back to me with, “That’s a great idea,” and invited me to speak to 20 attorneys in Syracuse and 40 attorneys in Buffalo. I recently spoke again in Buffalo, also on pressure ulcers. I walked away with four great leads.
Consulting on Medical-Related Cases Has Stretched Me
In nursing things are quick – you have a low potassium reading, you supplement it and move on to the next problem. In the CLNC world, everything moves slower, which was an eye-opener for me.
I’ve had 12 cases so far, and only two have closed. The attorney keeps calling with different requests on one case (involving a schizophrenic) that is approaching trial. And I confess, this case has stretched me a bit.
The plaintiff attended an adult daycare center from 9:00am to 1:00pm, Monday through Friday. He had behavioral, hygiene and combative-abusive issues. During the course of his illness he became a diabetic and also developed MS. Periodically, if he had to walk for an extended time, he used a wheelchair. Progression was to the point that he was having trouble swallowing.
One day at daycare, he choked on a chicken sandwich he wasn’t supposed to have. The daycare staff knew this wasn’t a type of food he should eat, but he sent a buddy to buy it. He choked and is currently in a vegetative state. At present, he’s in a long term care facility, but his mom would like to bring him home.
As the case has progressed, I’ve had to research standards of care for adult daycare centers. The daycare facility provided diabetic instruction from a nurse who was on staff Monday through Friday. I looked through her employment record. This woman didn’t take many days off. Unfortunately, she did take this day off.
Without her, nobody assisted the choking patient until the paramedics arrived. No one was trained to do what might possibly have helped this man, such as: Get the stuff out of his throat! Do the Heimlich on him!
I listened to some of the verbiage from the 911 call. “We don’t know how to do that. How do you do that?” The operator said, “Just put him on his side,” and they responded, “We can’t do that. He’s in a wheelchair. ” And, “We don’t want to touch him. Foam is coming from his mouth.”
My job was to research all that happened that day, how and why, which I did.
Back to the Core Curriculum for Legal Nurse Consulting® Textbook
About six months later the attorney called. “There are six defendants,” he said. “I’d like you to write deposition questions for all six.” He was planning to interview the fire department, the paramedics, the social worker on staff, director of the facility, and others. Okay…except…I’d never written deposition questions before.
After referring back to Vickie Milazzo Instititute’s Core Curriculum for Legal Nurse Consulting textbook, I realized, Yes, I can do this. Once I was on a roll with each question, I would think, What about this? And this? Then I had to do research. For example, EMTs use specific equipment to verify oxygenation, the carbon dioxide in his blood, things like that, so I had to educate myself. In the end, I came up with 360 questions. The attorney was extremely pleased.
What’s interesting is that I’d never met this attorney. During all the months we worked together, everything was by phone, email or text message. He asked me to come in as he was preparing to take depositions and wanted to go over everything together.
This was my opportunity to meet him in person and get to know his staff, so I wore my power suit. Vickie would be proud. We made such a good connection that when I was leaving, he said, “You know, Debbie, you’re my go-to person.”
I smiled and calmly thanked him, but inside I was screaming…Yes!!!
The Reward of Being Appreciated by Attorneys Is Exciting
Six months went by, with two major attorneys working on this case. As they’re on the way to court for jury selection, I get a call.
“I need you to research the life expectancy of a person in a vegetative state, plus with diabetes, plus with hypertension, plus with this, this and this.” I received the call on Thursday. He finished by saying, “I need it all by Monday.”
So I buried myself in the case and got it done. By Sunday night, I had the information he needed. I then emailed it to him so he’d have a chance to look at it Sunday night. Monday morning, I called and went over everything. He was due in court at 11:00am. He was happy. As I said, this case challenged me, but the outcome is going to be good.
A different attorney from the Syracuse conference hired me for a nursing home case. Naturally, I was thrilled that I attended. This was a case that settled, and at 8:00pm one night I received a call from the attorney. Driving to Vermont, he apparently had tried to reach me several times, but we kept missing each other. When we finally connected, he said, “I was not going to leave a message or email you or text. I wanted to tell you in person. Because of your knowledge, your work product and how you helped me on this case, we had a very favorable outcome. I really appreciate your involvement.”
That was the jolt, the big pat on the back, that made me believe, Oh, my goodness, I can do this. I’ve never had an issue with charging $125 an hour. The attorneys always come back with, “Your fees sound fine, here’s what we need.” I send my invoice and receive a check in the mail a few weeks later. Payment has never been a problem.
I tell my RN friends, You can do this. Part time, full time – you can be a Certified Legal Nurse Consultant from your dining table or from a wheelchair – and my gosh, do you make money!
Guest Blogger Profile
Debbie L. Mitro, RN, BSN, CWON, CLNC owns Mitro Legal Nursing and consults throughout New York. She has more than 30 years of nursing experience and specializes in pressure ulcers. Debbie’s expertise also includes acute care, long term care, discharge planning and testifying.
P.S. Comment here to congratulate Debbie on her CLNC success and to share your area of specialty.